Rotator Cuff Tear and Associated Risk Factors. The Mutual Role of Medical Conditions.

Abstract

Several medical conditions (diabetes, cardio-vascular diseases, hypercholesterolemia etc.) or modifiable behavioral habits (smoking habit and alcohol assumption) capable of causing a damage to the peripheral microcirculation are considered potential risk factors for degeneration/tear of the rotator cuff. The aim of the study was to analyse and quantify how the association of multiple known risk factors is more effective than the predisposing action of a single factor. 308 consecutive patients who underwent arthroscopic repair of a full-thickness Rotator Cuff Tear (RCT) represented the case group. The control group included 388 consecutive healthy asymptomatic subjects for shoulder pathologies. A multivariable prognostic model for the prediction of rotator cuff tear has been performed to analyse the mutual effect of multiple risk factors. With a correct classification estimated at 70.6% a smoker patient (OR=2.405; CI95%=1.645-3.516) with hypercholesterolemia (OR=1.976; CI95%=1.408-2.771), diabetes (OR=2.362; CI95%=1.241-4.493) and arterial hypertension (OR=1.630; CI95%=1.156-2.300) has a higher chance of developing a rotator cuff tear surgery compared to a peer non-smoker healthy subject. Probability of a smoker patient suffering from hypercholesterolemia, diabetes, and arterial hypertension to undergo rotator cuff repair surgery is not given by the sum of the probabilities of each condition but increases drammatically. Each pathology interacts with each other; dramatically increasing the risk of developing a cuff tear.

Level of evidence: III Retrospective Study.